POS0623 SUBCLINICAL ATHEROSCLEROSIS IS NOT RELATED WITH ACID URIC IN RHEUMATOID ARTHRITIS. STUDY OF 1005 PATIENTS OF A SINGLE UNIVERSITY HOSPITAL
Authors: F. Benavides-Villanueva, C. Corrales-Selaya, I. Ferraz-Amaro, N. Vegas-Revenga, V. Portilla, R. Blanco, M. A. González-Gay, A. Corrales
Journal: Annals of the Rheumatic Diseases (2022)

Background Rheumatoid Arthritis (RA) and Gout are associated with an increase of cardiovascular (CV) disease (1,2). Carotid plaques and increased carotid intima-media thickness (cIMT) are surrogate markers of CV mortality (3 ). The association of serum uric acid (SUA) levels as an independent factor of subclinical Atherosclerosis and mortality in RA remains not fully clarified (4,5). Objectives In a wide cohort of patients with RA our aims were to assess the relationship of SUA with a ) CV risk factors and b ) presence of atherosclerosis. Methods Cross-sectional study including 1005 patients with RA from a Single University Center. The presence of Atherosclerosis (c-IMT and carotid plaque) was explored by Carotid Ultrasonography. The relationship between SUA and markers of subclinical atherosclerosis was studied through linear regression and logistic multivariate analysis. Results We studied 1005 RA patients (741 women, 74%), mean age 61±13. The main general features, CV risks factors, RA activity data and current therapy are summarized in Table 1. Table 1. Main features of 1005 RA patients GENERAL FEATURES RESULTS GENERAL FEATURES (CONTINUATION) RESULTS (CONTINUATION) Age, years, mean±SD 60±13 RA features Female/ Male, n (%) 741 (74) / 264 (26) RA duration, years; mean±SD 17±12 CRP, mg/L, median, [IQR] 3.0 [0.9-7.5] CV risk factors ESR, mm/ 1st hour; median, [IQR] 14 [6-24] Past or Current smoker, n (%) 539 (54) Rheumatoid factor, n (%) 528 (53) Obesity/ Dyslipidemia, n (%) 307 (31)/ 560 (56) ACPA, n (%) 492 (50) Hypertension, n (%) 453 (45) DAS28-ESR; mean±SD 3.3 ± 1.5 Diabetes Mellitus, n (%) 127 (13) DAS28-CRP; mean±SD 3.1 ± 1.3 BMI, kg/m2, mean±SD 28±5/93±15 Uric acid Abdominal circumference cm; mean±SD Uric acid level (mg/dl); mean±SD 4.8 ± 1.4 Previous CV Events, n (%) 125 (12) Chronic Kidney Disease, n (%) 58 (6) Carotid Ultrasonography Gout / using drugs for hyperuricemia; n (%) 20 (2) cIMT microns; mean±SD 708 ± 157 Total cholesterol, mg/dl; mean±SD 201±39 Carotid plaque¸ n (%) 617 (62) HDL cholesterol, mg/dl; mean±SD 61±17 LDL cholesterol, mg/dl; mean±SD 119 ± 32 Abbreviations: ACPA: Anti–citrullinated protein antibody; BMI: Body mass index; CV: Cardiovascular; cIMT: carotid intima-media thickness; cm: centimeter; CRP: C Reactive protein; DAS28-ESR: Disease Activity Score-28 for Rheumatoid Arthritis with Erythrocyte Sedimentation Rate; DAS28-PCR: Disease Activity Score-28 for Rheumatoid Arthritis with C reactive protein; dl: deciliter; ESR: Erythrocyte Sedimentation Rate; HDL: high-density lipoprotein; IQR: Interquartile range; Kg: kilogram; LDL: Low-density lipoprotein; mg: milligram; m2: square meter; n: number; RA: Rheumatoid Arthritis; SD: Standard Deviation. SUA as a dependent variable was significantly correlated with age, male gender and most of CV risk factors (body mass index, abdominal circumference and obesity) (single-variable analysis). Similarly, a significative beta coef. [95%CI] positive relationship with SUA was observed with hypertension (0.7 [0.5-0.8], p&lt;0.001), diabetes (0.5 [0.2-0.7], p&lt;0.001), dyslipidemia (0.2 [0.04-0.4], p=0.016), renal chronic insufficiency (1.5 [95CI 1.1-0.8], p&lt;0.001) and previous CV events (0.8 [0.4-1.2], p&lt;0.001). Subclinical Atherosclerosis, as dependent variable, was significantly correlated with SUA (single-variable analysis). In addition, SUA showed a positive significative beta coef. [95%CI] relationship with cIMT (18 [12-25], p&lt;0.001) and the presence of carotid plaques (1.29 [17-1.42], p&lt;0.001). However, statistical significance was not observed in the multivariable analysis adjusted by Classic CV Risk Factors. Conclusion In RA, SUA is related with most of CV risk factors. However, SUA is not associated with Subclinical Atherosclerosis. References [1]Aviña-Zubieta JA, et al. Arthritis Rheum. 2008,15;59:1690-7. [2]Klein R, et al. Arch Intern Med 1973, 132:401–410. [3]de Groot E, et al. Circulation, 2004,109:33–38. [4]Lauren Shahin, et al Cureus 2021. 5; 13.:e14855. [5]Chiou A, et al. Arthritis Care Res (Hoboken). 2020, 72:950-958. Disclosure of Interests None declared